Why do eyelids twitch?

You may have heard the saying: "Left eye twitching means wealth, right eye twitching means disaster." We won’t discuss metaphysics or anything like that. Today, let’s talk about eyelid twitching in medicine.

Why do my eyelids twitch?

Eyelid twitching is clinically known as eyelid tremor or blepharospasm, which is usually caused by involuntary contraction of the orbicularis oculi muscle or levator palpebrae superioris muscle that controls the opening and closing of the eyelids. Blepharospasm can be divided into primary blepharospasm and secondary blepharospasm.

Essential blepharospasm :

This type of eyelid twitching is usually sporadic, and the cause is unclear. It may be related to fatigue, lack of sleep, mental stress, excessive use of the eyes, or the following factors:

Vascular factors : Abnormalities or variations in brain blood vessels, such as lesions of the anterior inferior cerebellar artery, posterior inferior cerebellar artery, and labyrinthine artery, may compress the root of the facial nerve.

Neurological factors : Dysfunction of central nervous system neurons and cranial nerves V and VII may be related to the pathogenesis of the disease. Damage to the basal ganglia and hypofunction of γ-aminobutyric acid neurons in the substantia nigra and striatum are also related to blepharospasm.

Genetic and environmental factors : Essential blepharospasm is an autosomal dominant genetic disease.

Secondary blepharospasm:

Blepharospasm may be caused by other diseases, such as keratoconjunctivitis, trichiasis, acute iritis, middle ear mastoiditis, tumors, and encephalitis, which cause irritation of the eyelid reflex pathway.

How to treat blepharospasm?

Depending on the degree of muscle spasm, blepharospasm is divided into mild, moderate and severe. When the symptoms are mild, we can relieve them by adjusting the lifestyle, using local anti-fatigue eye drops and ice compresses.

At present, the cause and pathogenesis of blepharospasm are unknown, and treatment is tentative. The most common treatment is local injection of botulinum toxin, which can quickly and firmly bind to the muscles, act on the cholinergic motor nerve endings, interfere with the release of acetylcholine, and prevent the contraction of muscle fibers. Blepharospasm can cause difficulty in opening the eyes and affect visual function, facial beauty and appearance, thereby affecting normal social activities; in addition, if blepharospasm is not treated for a long time, facial nerve damage will be aggravated, and it may also cause a series of concurrent facial diseases such as facial muscle contracture, synkinesis, hemifacial spasm, and ptosis.

Therefore, when frequent "eyelid twitching" occurs and the symptoms do not improve for a long time or disappear on their own, it is recommended to seek medical attention as soon as possible, find out the cause, and receive standardized treatment.